Individual
ALICE K ASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
30 S 200 W, BURLEY, ID 83318-5018
(208) 431-1718
Mailing address
30 S 200 W, BURLEY, ID 83318-5018
(208) 431-1718
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
ID
Other
Enumeration date
04/12/2010
Last updated
04/12/2010
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